Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee.
Am J Addict. 2014 Jan-Feb;23(1):62-7. doi: 10.1111/j.1521-0391.2013.12074.x. Epub 2013 Jun 10.
Despite the dramatic increase in the use of buprenorphine for the treatment of opioid dependence, clinical outcomes of this treatment approach continue to need evaluation. This study examines factors associated with relapse and retention during buprenorphine treatment in a sample of opioid dependent outpatients.
In a retrospective chart review of 62 patients with opioid dependence, relapse was determined by self-report, urine toxicology screens, and by checking the state controlled substance monitoring database. Data was analyzed using two-way tests of association and logistic regression.
Patients with comorbid anxiety disorders, active benzodiazepine use (contrary to clinic policy), or active alcohol abuse, were significantly more likely to relapse. Patients who relapsed were also more likely to be on a higher buprenorphine maintenance dose.
This study identifies relapse risk factors during buprenorphine treatment for opioid dependence. Future research is needed to determine whether modifying these factors may lead to improved treatment outcomes.
尽管丁丙诺啡在治疗阿片类药物依赖方面的使用急剧增加,但这种治疗方法的临床效果仍需要评估。本研究旨在探讨在一组阿片类药物依赖门诊患者中,与丁丙诺啡治疗期间复发和保留相关的因素。
对 62 名阿片类药物依赖患者进行回顾性图表审查,通过自我报告、尿液毒理学筛查和检查州管制物质监测数据库来确定复发。使用双向关联检验和逻辑回归进行数据分析。
合并焦虑障碍、正在使用苯二氮䓬类药物(违反诊所政策)或正在滥用酒精的患者复发的可能性显著更高。复发的患者也更有可能接受更高剂量的丁丙诺啡维持治疗。
本研究确定了丁丙诺啡治疗阿片类药物依赖期间的复发风险因素。需要进一步研究以确定是否可以通过改变这些因素来改善治疗结果。